The Presidential Candidates' Positions on the Private Healthcare System and the Patient Protection and Affordable Care Act (a.k.a. Obamacare)
Healthcare will be an important issue for employers and individuals in the upcoming presidential election, and, given its relevance to one of my practice areas, I decided to summarize the candidates’ current positions. Note that I focused only on private healthcare and left out Medicare, Medicaid, and SCHIP.
To ascertain their positions, I started with the candidates’ websites, then looked at any specific written proposals they made, and, finally, turned to other publicly available sources. For Clinton and Trump I thought it worthwhile to include their prior positions on healthcare issues even though they may not be advocating for those positions in this campaign.
I arranged the leading candidates alphabetically according to party (blue for D’s, red for R’s). I left a few candidates from both parties out of the chart based on my own determination that they stand little chance. Also, the R’s got an extra row, “All Republican Candidates,” because they all support repealing the ACA (no sense in repeating the same thing for every candidate).
Let me offer three observations about the information presented:
- First, at this stage, Bush, Clinton and Sanders offer the most details about their plans.
- Second, the marketplace is already using a lot of ideas all the candidates in both parties propose. For example, when you hear about getting value (better health outcomes) and lowering costs, insurers and providers are already using a variety of methods—including Accountable Care Organizations and bundled/episode of care payments—to achieve those goals. Similarly, a lot of candidates are focusing on improving medical innovation, streamlining the FDA and getting more funding for NIH, but some of those ideas are already in the 21st Century America Cures Act. These examples aren’t meant as a criticism of the candidates’ proposals. I only intend to point out that the candidates’ proposals may not be a radical departure from present practice.
- Third, if you compare the leading Democratic Party candidate to the Republican Party candidates, some of the concepts and goals sound similar. It is likely to be the means, not the ends, where the differences arise.